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目的探讨抗病毒治疗对住院慢性乙型肝炎病毒(HBV)感染者疾病谱构成比的影响。方法对2011年在中山大学附属第三医院感染科住院的1 619例慢性HBV感染者进行回顾性调查分析,根据入院前是否有抗病毒治疗情况分为抗病毒组(n=279)和对照组(n=1 340);根据是否按医嘱规范治疗,将279例抗病毒患者分为规范抗病毒组(n=198)及不规范抗病毒组(n=81);再根据入院时HBV DNA水平不同(≥100IU/ml或<100IU/ml),将198例规范抗病毒组患者细分为HBV DNA阳性组(n=66)及HBV DNA阴性组(n=132),并分别比较两组的疾病谱构成比的分布情况。采用SPSS 16.0统计软件,组间均数的比较采用t检验或秩和检验,率的比较采用χ2检验或Fisher′s精确概率法检验,P<0.05为差异有统计学意义。结果抗病毒组与对照组的疾病谱构成比分布比较差异有统计学意义(P<0.05),其中抗病毒组诊断为慢性乙型肝炎(重度)、慢性乙型肝炎(重型)的比例低于对照组(10.0%vs 25.9%,P<0.05;3.6%vs 13.4%,P<0.05),而诊断为乙肝肝硬化的比例高于对照组(74.2%vs 44.8%,P<0.05),差异均有统计学意义;规范抗病毒组与不规范抗病毒组的疾病谱构成比分布比较差异亦有统计学意义(P<0.05);规范抗病毒组中HBV DNA阳性及阴性亚组的疾病谱构成比分布比较差异亦有统计学意义(P<0.05)。结论规范且有效的抗病毒治疗确实可以减少慢性乙型肝炎患者因肝炎活动而住院的比例,从而改变住院慢性HBV感染者的疾病谱构成比。
Objective To investigate the effect of antiviral therapy on the composition of disease spectrum in hospitalized patients with chronic hepatitis B virus (HBV) infection. Methods A retrospective analysis was conducted on 1,619 patients with chronic HBV infection admitted to the Department of Infectious Diseases, Third Affiliated Hospital of Sun Yat-sen University in 2011. The patients were divided into antivirus group (n = 279) and control group according to whether antiviral therapy was given before admission. (n = 1 340) .According to whether the prescription treatment according to doctor’s advice, 279 patients with antiviral therapy were divided into the standard antivirus group (n = 198) and the non-standard antivirus group (n = 81) (N = 66) and HBV DNA negative group (n = 132) were divided into two groups according to their different levels (≥100IU / ml or <100IU / ml) Distribution of disease spectrum composition ratio. Using SPSS 16.0 statistical software, the comparison of mean between groups using t test or rank sum test, the rate of comparison using χ2 test or Fisher’s exact test, P <0.05 for the difference was statistically significant. Results There were significant differences in the distribution of disease spectrum between the antiviral group and the control group (P <0.05). Among the antiviral group, the proportion of chronic hepatitis B (severe) and chronic hepatitis B The percentage of patients diagnosed with hepatitis B cirrhosis was higher than that of the control group (74.2% vs 44.8%, P <0.05), and the difference was significant among the control group (10.0% vs 25.9%, P <0.05; 3.6% vs 13.4%, P < (P <0.05). The disease spectrum of the positive and negative HBV DNA in the standard antiviral group was significantly different from that in the standard antiviral group The difference was also statistically significant (P <0.05). Conclusion Standardized and effective antiretroviral therapy can indeed reduce the proportion of hospitalized patients with chronic hepatitis B due to hepatitis activity, thus changing the disease spectrum ratio of hospitalized patients with chronic HBV infection.